Psychiatry & Psychotherapy Podcast Borderline Personality Disorder: Splitting & Identity Diffusion with Mark Ruffalo
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Jan 10, 2025 Mark Ruffalo, acclaimed actor and mental health advocate, discusses the intricacies of borderline personality disorder (BPD). He explores the historical evolution of BPD diagnosis, highlighting key concepts like splitting and identity diffusion. The conversation addresses the impact of childhood trauma on self-concept and relationships, along with effective therapeutic approaches. Ruffalo emphasizes the importance of empathy in treatment and delves into the emotional dynamics between therapists and patients, offering profound insights for understanding this complex condition.
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BPD History
- Borderline personality disorder (BPD) has a long history of evolving terminology.
- From "latent schizophrenia" to "pseudoneurotic schizophrenia," it became a distinct DSM diagnosis in 1980, thanks to Gunderson.
Reflective Function in BPD
- Reflective function, not just therapeutic alliance, is key in BPD therapy.
- It involves improving the patient's and therapist's ability to understand mental states, using transference and countertransference.
Dissociative Transference
- Dr. Puder had a patient with a dissociative transference, where he felt like a ghost-like figure.
- It took 1.5 years of consistent presence to resolve, showing how deeply ingrained these patterns can be.